A Kingston family doctor has organized a petition to the Ontario government on behalf of a fellow family physician who is being ordered to repay more than half a million dollars to the Ontario Health Insurance Plan (OHIP). Dr. Veronica Legnini said that she “pounded the pavement” over the weekend, so that the petition could be present in the Ontario legislature on Monday. Ted Hsu, Liberal member of provincial parliament for Kingston and the Islands, brought the petition on behalf of more than 100 signees that request the government stop demanding repayment from Dr. Elaine Ma, money that the petition says, “she earned for her heroic efforts to vaccinate Ontarians during the COVID-19 pandemic.” “We the undersigned petition the Legislative Assembly of Ontario as follows: To call on Premier Doug Ford and Health Minister, Sylvia Jones, to demonstrate their commitment to Ontario healthcare workers by ordering OHIP to set aside the (Health Services Appeal and Review Board) decision and to cease demanding repayment of earned billings,” the petition reads. On Nov. 26, Ontario Health Services Appeal and Review Board ruled that Ma should repay $600,962.61, plus interest, for billings that she made during a number of large-scale drive through COVID-19 vaccination clinics she organized between July 2021 and January 2022. The clinics were organized by Ma in collaboration with health-care professionals, students at Queen’s University, the local public health unit and others, many of whom volunteered their time to administer several thousand vaccines at the height of the pandemic. Ma organized approximately 45 drive-through vaccine clinics that administered around 35,000 doses of COVID-19 vaccine. Her efforts were recognized by the Ontario Medical Association and beyond, and the Kingston region’s medical officer of health, Dr. Piotr Oglaza, pointed to Ma’s efforts as being pivotal in helping the KFL&A region achieve the best vaccine coverage rate in the province. But the Ontario government has ruled that Ma’s billings were made erroneously, due to the fact that the vaccinations were administered outside of her personal office, and by people who were not technically her employees, requirements for OHIP coverage for the billing codes she used. Legnini said that the ruling against Ma is a terrifying prospect for other physicians, including herself, who fear that OHIP will be coming after them next. She and other doctors in Kingston have used the drive-through clinic model that Ma utilized, just not on such a large scale. Legnini and others have cancelled planned community drive-through vaccination clinics in the wake of Ma’s experience with OHIP. “I’ve done flu shot clinics and I’ve done COVID vaccine clinics, and I’ll be very frank with you. We’re all afraid of being targeted by OHIP,” Legnini said. “So many doctors wouldn’t even sign the petition. Lots of people told me, ‘I’m scared OHIP is going to target me for something.’” She is disillusioned with the mixed messaging that the ruling against Ma suggests. “I remember what it was like on those provincial phone calls,” she said. “You had General Hillier, the head of the COVID-19 task force, saying, ‘Get it done. We’ll make it right.’ Doug Ford came on those calls and he said, ‘Just get it done, whatever you have to do, we’ll make it right later.’ The messaging was really there from all levels of government.” Ma’s clinics, praised as innovative, had support from the city, from local public health and other professionals, Legnini said. “Many, many physicians came to those clinics, Queen’s directed students to those clinics. People came and volunteered from all walks of life. Nurses came, even though they were tired and working hard at the hospital. It was really an amazing thing to see and be a part of.” Legnini said that it was “no secret” that drive-through clinics were being organized by other doctors in the Kingston community. She doesn’t know if or when OHIP will pursue action against others. “I do worry that I’m going to be next,” she admitted. Legnini said that the ruling is also going to affect the training of medical students going forward. Ma is being penalized for billing for vaccine administration that was delegated to medical students and volunteers who were not technically her employees. OHIP representatives referenced a 2001 document during Ma’s hearing that provides the supporting definition of “staff” that allowed the province to rule against Ma’s billing. “I have colleagues at other offices who, after this ruling, they’re really looking hard at their staffing and saying, well, if OHIP is saying she can’t go for that delegated act, I may have to let go of some staff because otherwise, what’s the point?” Legnini said that most doctors do not get paid to teach student physicians. “Honestly, it’s a wonderful thing to do, but it’s an investment in time and money. If you even lose that bit of billing (potential), it can make a difference for a doctor, and lots of groups are already looking at their structure, in terms of employees and medical students.” With Ontario doctors-in-training already having difficulty finding hands-on education, Legnini said that the ruling will have more negative impacts. “If this (ruling) stands, then looking ahead beyond the next election we will see even worsening access to quality medical education for medical students, less employment opportunities in health care and less patient access to any care, let alone team-based care,” Legnini said. “My clinic already did not run our traditional drive through clinics for flu shots, which we have done for many years, even before COVID.” Since the ruling at the end of November, community members have rallied to show support to Ma, with more than 4,000 signatures on an online petition asking the Ford government to reconsider Ma’s case. Kingston city council members voiced their support for Ma during a recent council meeting, unanimously backing a motion calling for the province to intervene in the Health Services Appeal and Review Board decision. Hsu said that it is his job to present any petition brought to him by his constituents, but that he has also already spoken out in the house in support of Ma’s pandemic-time efforts. A petition formally presented in the Legislative Assembly of Ontario “asks the Legislature to act on or change its position on an issue,” according to the government’s website. Once a petition is presented, the government is required to file a response within 24 sessional days. In an interview with the Whig-Standard at the end of November, Hsu said that he is concerned about how this ruling will affect health-care professionals going forward. “Doctors had to take the initiative to organize these completely new clinics, the sort of thing that had never been done before,” he said. “The question in my head is, in the next public health emergency, will doctors step up and take the initiative when it is required?” Legnini praised Ma’s unconventional approach to mass vaccination, which allowed people to stay socially distanced and safe during times of public health measures. “The degree of personal liability Dr. Ma took on willingly is incredible,” Legnini said. “I never would have spearheaded an operation of this scale. And if a large-scale corporation had offered to get this work done for the same cost per shot, but twenty times as quickly as a traditional clinic, and over the holidays in the cold, we’d be singing their praises. And their CEO would get a bonus.” In a supplied statement on Tuesday, the Ontario Medical Association said that doctors “were called upon to perform heroically in the midst of a crisis” during the COVID-19 pandemic. “Now, years later, it’s disheartening to our members to see this kind of reaction to their efforts and a lack of understanding of the depth and breadth of the sacrifices they made to keep us all safe. It is concerning that a physician who provided care to their community during the pandemic is now facing this outcome.” mbalogh@postmedia.comWARNING: This story contains details that may distress readers. A stampede at a football match dedicated to Guinea’s junta chief killed at least 56 people, the government said on Tuesday morning (AEDT). In a shocking development following the tragedy, the opposition has accused the military-led authorities of being “directly responsible”. Spectators at Monday’s game in the country’s second-largest city of N’Zerekore invaded the pitch after one or two players were sent off and a penalty was awarded to the opposing side Labe at the end of the game, witnesses said. The events had initially been reported as clashes between fans. Officials watching the match, including two ministers, were prevented from leaving, prompting stone throwing and the firing of tear gas by security forces, a witness said, speaking on condition of anonymity. “Panic quickly set in, leading to an uncontrollable stampede,” he said. “People were trampled underfoot or injured as they tried to flee,” he added. One AFP journalist described the scenes as “mass carnage”. The match in the southeastern city was the final of a tournament organised in honour of Guinea’s junta leader, General Mamady Doumbouya, who seized power in a 2021 coup and has installed himself as president. The opposition has accused the junta of using sport for political ends. Videos circulating on social media, which AFP was unable to immediately verify, show a huge crowd packed in the dilapidated stadium. “The thousands of people at the stadium were gripped by panic and fear. It was every man for himself,” said a local official, speaking on condition of anonymity. “Protests of dissatisfaction with refereeing decisions led to stone-throwing by supporters, resulting in fatal stampedes,” the government said in a statement which was read out on national television. Spectators were seen fleeing the venue. Photo: Reuters. “Hospital services have put the provisional death toll at 56, with several others injured,” it added, describing the incident as a “tragic event”. On Monday, a doctor earlier described horrific scenes at medical facilities. “There are bodies lined up as far as the eye can see in the hospital. Others are lying on the floor in the hallways. The morgue is full,” one doctor said on condition of anonymity because he was not authorised to speak to the media. He said “there are around 100 dead”, with bodies filling the local hospital and morgue. Videos posted on social media showed chaotic scenes, with people climbing what appear to be the stadium’s perimeter walls to escape. Others showed numerous bodies lying on the ground. Doctors told AFP on Sunday that dozens had died. Access to verified information in the remote part of the West African country is limited. Local media reported that hospital wards and a morgue were overwhelmed by the injured and dead. “The government is doing everything possible to respond to this tragic event,” Doumbouya said in a statement on social media. “An emergency mission led by the prime minister has been dispatched,” he added. Spectators were crushed in the sickening scenes. Photo: BBC via Nimba Sport Zaly. Thousands were caught. Photo: Twitter. Doumbouya said a commission of enquiry would be set up “to rule on the causes of this tragedy and to determine who is responsible”. The junta chief called for calm in the West African nation, which has a turbulent political history and remains poor despite considerable natural resources. The crackdown on an opposition rally at a stadium in the capital Conakry left at least 156 people dead in 2009, according to a UN-mandated international commission of enquiry. Such football tournaments and other public gatherings have become common in Guinea in recent weeks, in what is widely seen as a campaign to promote Doumbouya’s candidacy in any future presidential election. The military seized power by force in September 2021 by overthrowing civilian President Alpha Conde. Under international pressure, the junta pledged to hand power back to a civilian government by the end of 2024 but has since made clear it will not. Several of Doumbouya’s aides have recently expressed their support for his possible presidential bid. One of the last remaining dissident voices in Guinea, the National Front for the Defence of the Constitution (FNDC), published a statement expressing its “outrage” at the tragedy in N’Zerekore. It said it held the junta chief and his government “directly responsible for this disaster, which cost the lives of innocent citizens, including many children”. “This demonstrates the cynical use of sport by the junta, exploiting these images of mobilisation for political ends,” the statement added. Former president Conde expressed “profound sadness and boundless outrage” in a social media post. “In a context where the country is already marked by tensions and restrictions, this tragedy highlights the dangers of irresponsible organisation and a lack of adequate preparation,” he said. 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